Rib fractures continue to be a common occurrence in trauma patients of all ages. Traumatic
rib fractures can cause severe pain in patients and lead to shallow breathing and further
complications such as the need for mechanical ventilation, hospital or ventilator associated
pneumonia, atelectasis, and acute respiratory distress syndrome. Effective multimodal pain
management is needed to optimize a patient's respiratory status and can also play a role in
early mobility, less pulmonary complications, shorter ICU and hospital length of stay, and
decreased mortality. Current multimodal pain management options include opioids, muscle
relaxants, gabapentin, acetaminophen, nonsteroidal anti-inflammatory drugs, and various
regional/neuraxial anesthesia techniques. Both ketamine and lidocaine infusions for pain
control have also been shown in studies to be safe and effective, with the benefit of
minimizing the use of opioids. However, there have been very few studies that have used
ketamine or lidocaine infusions for pain control specifically in patients with traumatic rib
fractures. Therefore, the purpose of this study is to evaluate ketamine versus lidocaine
infusions as an adjunctive therapy to reduce opioid consumption in the first 72 hours in
patients with multiple traumatic rib fractures.